Cardiovascular diseases

September 2011

Key facts

  • Deaths from cancer worldwide are projected to continue to rise to over 11 million in 2030.
  • Cardiovascular diseases CVDs are the number one cause of death globally.
  • More people die annually from CVDs than from any other cause.
  • An estimated 17.3 million people died from CVDs in 2008, representing 30% of all global deaths. Of these deaths, an estimated 7.3 million were due to coronary heart disease and 6.2 million were due to stroke.
  • Low- and middle-income countries are disproportionally affected: over 80% of CVD deaths take place in low- and middle-income countries and occur almost equally in men and women.
  • By 2030, almost 23.6 million people will die from CVDs, mainly from heart disease and stroke. These are projected to remain the single leading causes of death.

Cardiovascular diseases

  • Heart attacks and strokes are usually acute events and are mainly caused by a blockage that prevents blood from flowing to the heart or brain. The most common reason for this is a build-up of fatty deposits on the inner walls of the blood vessels that supply the heart or brain.
  • Strokes can also be caused by bleeding from a blood vessel in the brain or from blood clots.
  • Cardiovascular diseases (CVDs) include:
  • Coronary heart disease – disease of the blood vessels supplying the heart muscle.
  • Cerebrovascular disease - disease of the blood vessels supplying the brain.
  • Peipheral arterial disease – disease of blood vessels supplying the arms and legs.
  • Rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria.
  • Congenital heart disease – malformations of heart structure existing at birth.
  • Deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs.

Risk factors for cardiovascular disease

  • The most important behavioural risk factors of heart disease and stroke are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. Behavioural risk factors are responsible for about 80% of coronary heart disease and cerebrovascular disease.
  • The effects of unhealthy diet and physical inactivity may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity; these are called "intermediate risk factors" or metabolic risk factors.
  • There are also a number of underlying determinants of CVDs, or "the causes of the causes". These are a reflection of the major forces driving social, economic and cultural change – globalization, urbanization, and population ageing. Other determinants of CVDs include poverty, stress and hereditary factors.

Symptoms of cardiovascular diseases

  • Often, there are no symptoms of the underlying disease of the blood vessels. A heart attack or stroke may be the first warning of underlying disease.
  • Symptoms of a heart attack include: pain or discomfort in the centre of the chest; pain or discomfort in the arms, the left shoulder, elbows, jaw, or back.
  • In addition the person may experience difficulty in breathing or shortness of breath; feeling sick or vomiting; feeling light-headed or faint; breaking into a cold sweat; and becoming pale.
  • Women are more likely to have shortness of breath, nausea, vomiting, and back or jaw pain.
  • The most common symptom of a stroke is sudden weakness of the face, arm, or leg, most often on one side of the body. Other symptoms include sudden onset of: numbness of the face, arm, or leg, especially on one side of the body; confusion, difficulty speaking or understanding speech; difficulty seeing with one or both eyes; difficulty walking, dizziness, loss of balance or coordination; severe headache with no known cause; and fainting or unconsciousness.

Rheumatic heart disease

Rheumatic heart disease is caused by damage to the heart valves and heart muscle from the inflammation and scarring caused by rheumatic fever. Rheumatic fever is caused by streptococcal bacteria, which usually begins as a sore throat or tonsillitis in children.

Rheumatic fever mostly affects children in developing countries, especially where poverty is widespread. Globally, almost 2% of deaths from cardiovascular diseases are related to rheumatic heart disease, while 42% of deaths from cardiovascular diseases are related to ischaemic heart disease, and 34% to cerebrovascular disease.

  • Symptoms
    • Symptoms of rheumatic heart disease include: shortness of breath, fatigue, irregular heart beats, chest pain and fainting.
    • Symptoms of rheumatic fever include: fever, pain and swelling of the joints, nausea, stomach cramps and vomiting.
  • Treatment
    • Early treatment of streptococcal sore throat can stop the development of rheumatic fever. Regular long-term penicillin treatment can prevent repeat attacks of rheumatic fever and can stop disease progression in people whose heart valves are already damaged by the disease.

Cardiovascular diseases in low- and middle-income countries?

  • Over 80% of the world's deaths from CVDs occur in low- and middle-income countries.
  • People in low- and middle-income countries are more exposed to risk factors leading to CVDs and other noncommunicable diseases and are less exposed to prevention efforts than people in high-income countries.
  • People in low- and middle-income countries who suffer from CVDs and other noncommunicable diseases have less access to effective and equitable health care services (including early detection services).
  • As a result, many people in low- and middle-income countries die younger from CVDs and other noncommunicable diseases, often in their most productive years.
  • The poorest people in low- and middle-income countries are affected most. At household level, evidence is emerging to prove that CVDs and other noncommunicable diseases contribute to poverty.
  • At macro-economic level, CVDs place a heavy burden on the economies of low- and middle-income countries. Heart disease, stroke and diabetes are estimated to reduce GDP between 1 and 5% in low- and middle-income countries experiencing rapid economic growth, as many people die prematurely.

Reducing the burden of cardiovascular diseases

Treatment

There is a need for increased government investment through national programmes aimed at prevention and control of CVDs and other noncommunicable diseases.

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